SHANETTA PATTERSON (NPI# 1780170639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780170639 |
| Entity Type | Individual |
| Full Name | SHANETTA PATTERSON |
| Practice Address |
5412 Boulder Hwy Las Vegas NV 89122-6039 |
| Mailing Address |
4791 E Craig Rd Unit C Las Vegas NV 89115-2576 |
| Practice Telephone | 7022917121 |
| Mailing Telephone | 7025267959 |
| Enumeration Date | 2018-07-03 |
| Last Update Date | 2018-07-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Street Address |
5412 BOULDER HWY |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89122-6039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346432374 | Pamela Hollis | Social Worker | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2007-08-14 |
| 1780283374 | Kelly Ann Waddilove | Case Manager/Care Coordinator | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-10-23 |
| 1942809157 | Christopher David Burns | Case Manager/Care Coordinator | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-10-19 |
| 1518564533 | Aimee Hollaway De Jesus | Counselor | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-10-02 |
| 1427662436 | Derick Ian Becios Manabat | Case Manager/Care Coordinator | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-09-07 |
| 1750994893 | Jeremie Bradford | Assistant Behavior Analyst | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-08-28 |
| 1093327116 | Hannah Nicole Schweinfurth | Assistant Behavior Analyst | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-08-19 |
| 1841818911 | Lucy Katende | Assistant Behavior Analyst | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-07-06 |
| 1114544863 | Jose Enrique Sandoval | Behavior Technician | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-06-29 |
| 1770106270 | Joseph N/a Ramirez | Behavior Technician | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902425523 | Dezirae Wilson | Technician | 5180 E Tropicana Ave Apt 46e, Las Vegas, NV 89122 | 2020-04-14 |
| 1407312366 | More Than Words LLC | Speech-Language Pathologist | 3430 Blue Ash Lane, Las Vegas, NV 89122 | 2019-02-15 |
| 1588130751 | Leslie Totress | Case Manager/Care Coordinator | 6368 Foxlyn Ave, Las Vegas, NV 89122 | 2018-10-15 |
| 1780100511 | Easy Living Behavioral Health LLC | Community Based Residential Treatment Facility, Mental Illness | 5069 Sun Valley Dr, Las Vegas, NV 89122 | 2017-08-14 |
| 1508381435 | Louie Taquiqui | Community/Behavioral Health | 3566 Tundra Swan St, Las Vegas, NE 89122 | 2017-08-11 |
| 1972032233 | Marilan Sanchez | Rehabilitation Practitioner | 5210 Emelita St, Las Vegas, NV 89122 | 2017-06-08 |
| 1023479599 | Tia Collins | Social Worker | 5412 Boulder Highway, Las Vegas, NV 89122 | 2016-03-11 |
| 1548673056 | Saba Chatoor | Counselor | 5446 Boulder Hwy Ste G3, Las Vegas, NV 89122 | 2014-06-03 |
| 1811328685 | Derrell Williams | Counselor | 3326 Wasatch Cedars St., Las Vegas, NV 89122 | 2013-12-04 |
| 1225466709 | The Lighthouse LLC | Community/Behavioral Health | 5710 E Tropicana Ave #2212, Las Vegas, NEVADA 89122 | 2013-10-22 |
| Find all providers in zip 89122 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
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| 1013548817 | Abraxas Center LLC | Clinic/Center | 4575 W Cougar Ave Ste 300, Las Vegas, NV 89139-7617 | 2020-01-30 |
| 1164061818 | Therapy Sense Pllc | Clinic/Center | 9402 W Lake Mead Blvd Ofc 104, Las Vegas, NV 89134-8312 | 2019-12-28 |
| 1932748779 | Mindworks Mental Health Clinic | Clinic/Center | 3830 Timberlake Dr., Las Vegas, NV 89115 | 2019-12-26 |
| 1205479813 | Core Strength LLC | Clinic/Center | 186 Woolman Rink Ave, Las Vegas, NV 89123-7443 | 2019-10-26 |
| 1164987871 | Brenda Primero Np LLC | Clinic/Center | 8125 Nottingham Hill Ln, Las Vegas, NV 89113-1888 | 2019-02-06 |
| 1699281915 | Desert Wellness Center | Clinic/Center | 3341 Ascona Ct, Las Vegas, NV 89129-6190 | 2017-12-22 |
| 1821537242 | Nicole R Vaughn Changing Minds | Clinic/Center | 911 N Buffalo Dr Unit 206, Las Vegas, NV 89128-0381 | 2017-02-17 |
| 1376090910 | Renaissance Ranch Outpatient, LLC | Clinic/Center | 3037 E Warm Springs Rd, Suite 400, Las Vegas, NV 89120-3758 | 2016-09-01 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.